This grant is divided into three parts. (1) An experimental laboratory study utilizing an ex-vivo, perfused canine pancreas preparation will investigate the possible role of triglycerides and free fatty acids in the pathogenesis of alcoholic acute pancreatitis. (2) This part of the experiment utilizes an ex-vivo, isolated, perfused, ventilated canine pulmonary lobe. This experimental preparation will be used to evaluate the possible toxic effects of triglycerides and fatty acids on gas exchange and pulmonary mechanics as a possible pathogenetic mechanism for respiratory failure in acute pancreatitis. In addition, the effect of lecithinase on gas exchange and pulmonary mechanics will be evaluated as an additional pathogenetic mechanism by which respiratory failure might be induced in acute pancreatitis. Finally, a clinical study will be carried out to document the incidence of triglyceride, free fatty acid, and lecithinase elevations (phospholipase A) in patients with acute pancreatitis and correlate these levels with arterial blood gases and clinical pulmonary status. (3) The final section will consist of a prospective randomized clinical study evaluating the efficacy of intramuscular atropine in acute pancreatitis.